A 76-year-old reports frequent nighttime awakenings, early m…
A 76-year-old reports frequent nighttime awakenings, early morning waking, and nonrestorative sleep. He has osteoarthritis, nocturia due to BPH, and takes a beta-blocker, a diuretic, and an evening dose of an SSRI. He asks why sleep has become more fragmented as he’s aged. You explain that while aging changes sleep architecture, the most common drivers of clinically significant insomnia and fragmentation are comorbidities and medication effects. Which factor most disrupts sleep in older adults?